SOUTHWEST LTC CROCKETT I, LTD. (NPI# 1487726329) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1487726329 |
| Entity Type | Organization |
| Organization Name | SOUTHWEST LTC CROCKETT I, LTD. |
| Other Organization Name | WHITEHALL NURSING CENTER |
| Practice Address |
1116 East Loop 304 Crockett TX 75835-1810 |
| Mailing Address |
17760 Preston Rd Suite 310 Dallas TX 75252-5663 |
| Practice Telephone | 4699166100 |
| Practice Fax Number | 4699166105 |
| Mailing Telephone | 4699166100 |
| Mailing Fax Number | 4699166105 |
| Enumeration Date | 2006-11-15 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | RONALD R. PAYNE (MANAGING MEMBER) |
| Authorized Official Telephone | 4699166100 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 314000000X | Skilled Nursing Facility | TX | Nursing & Custodial Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| TX | 4428 | 05 |
| Other Name | Type Code |
|---|---|
| Whitehall Nursing Center | Doing Business As Name - Organization |
| Street Address |
1116 EAST LOOP 304 |
| City | CROCKETT |
| State | TX |
| Zip Code | 75835-1810 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1568012862 | Ruby R. Adler | Technician | 2301 N 4th Street, Crockett, TX 75835 | 2019-09-18 |
| 1366712978 | Traditions Hospice of Madisonville, LLC | Hospice Care, Community Based | 600e Loop 304, Crockett, TX 75835 | 2012-01-12 |
| 1538458633 | Northeast Texas Home Health Agency Ltd | Home Health | 2001 E Houston Ave, Crockett, TX 75835 | 2011-03-30 |
| 1508096553 | D&c Medical Associates | Family Medicine | 1100 Loop 3048 East, Suite 200, Crockett, TX 75835 | 2009-07-23 |
| 1356466346 | John Vernon Garner | Dentist | 102 North Grace, Crockett, TX 75835 | 2007-03-20 |
| 1023148467 | Houston County Home Health Care, Inc. | Durable Medical Equipment & Medical Supplies | 1703 E Hwy 21 E, Crockett, TX 75835 | 2007-03-06 |
| 1407944382 | Davy Crockett Drug, Inc. | Pharmacy | 107 S 4th St, Crockett, TX 75835 | 2006-10-10 |
| 1437177052 | John Allan Burnett | Emergency Medicine | 1100 Loop 340 E, Crockett, TX 75835 | 2006-07-18 |
| 1720022593 | Stanley Roger Speegle | Family Medicine | 1100 Loop 304 East, Crockett, TX 75835 | 2006-06-15 |
| 1649219809 | Jeanne M. Hopple | Nurse Practitioner | The Heart Institute of East Texas, Crocket, 951 E. Loop 304, Crockett, TX 75835 | 2006-06-05 |
| Find all providers in zip 75835 | ||||
| Taxonomy Code | 314000000X |
| Grouping | Nursing & Custodial Care Facilities |
| Classification | Skilled Nursing Facility |
| (1) A skilled nursing facility is a facility or distinct part of an institution whose primary function is to provide medical, continuous nursing, and other health and social services to patients who are not in an acute phase of illness requiring services in a hospital, but who require primary restorative or skilled nursing services on an inpatient basis above the level of intermediate or custodial care in order to reach a degree of body functioning to permit self care in essential daily living. It meets any licensing or certification standards et forth by the jurisdiction where it is located. A skilled nursing facility may be a freestanding facility or part of a hospital that has been certified by Medicare to admit patients requiring subacute care and rehabilitation; (2) Provides non-acute medical and skilled nursing care services, therapy and social services under the supervision of a licensed registered nurse on a 24-hour basis. |
| Notes: Source: (1) "Glossary of terms used in managed care" Developed by the Managed Care Assembly (MCA) of Medical Group Management Association (MGMA), MGM Journal, September/October 1995, p. 64; (2) AHA Guide, 1996 Annual Survey. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1093069668 | Winfield Snf LLC | Skilled Nursing Facility | 1108 E Loop 304, Crockett, TX 75835-1810 | 2012-11-05 |
| 1376874586 | Pineview Nursing and Rehabilitation Center, LLC | Skilled Nursing Facility | 1150 Loop 304 East, Crockett, TX 75835-0000 | 2010-01-28 |
| 1275641458 | Grace Care of Texas | Skilled Nursing Facility | 1150 E Loop 304, Crockett, TX 75835-1810 | 2006-08-28 |
| 1215902440 | Whitehall Nursing Center, Ltd | Skilled Nursing Facility | 1116 E Loop 304, Crockett, TX 75835-1810 | 2006-02-21 |
| 1265407407 | Grapeland Nursing Center, Ltd | Skilled Nursing Facility | 1108 East Loop 304, Crockett, TX 75835-0997 | 2006-02-21 |
| 1427042217 | Grace Care of Texas, Inc. | Skilled Nursing Facility | 150 E Loop 304, Crockett, TX 75835 | 2005-09-07 |
| 1477093284 | Coryell County Memorial Hospital Authority | Skilled Nursing Facility | 1150 E Loop 304, Crockett, TX 75835-1810 | 2017-02-27 |
| 1730629544 | Coryell County Memorial Hospital Authority | Skilled Nursing Facility | 1108 E Loop 304, Crockett, TX 75835-1810 | 2017-02-27 |
| 1386184190 | Coryell County Memorial Hospital Authority | Skilled Nursing Facility | 1116 E Loop 304, Crockett, TX 75835-1810 | 2017-02-27 |
| 1437595824 | Crockett Snf LLC | Skilled Nursing Facility | 1150 E Loop 304, Crockett, TX 75835-1810 | 2013-05-13 |
| Find all providers in CROCKETT | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.